title: Pretreatment with low-energy shock waves reduces the renal oxidative stress and inflammation caused by high-energy shock wave lithotripsy.
abstract: The purpose of this study was to determine if pretreatment of porcine kidneys with low-energy shock waves (SWs) prior to delivery of a clinical dose of 2,000 SWs reduces or prevents shock wave lithotripsy (SWL)-induced acute oxidative stress and inflammation in the treated kidney. Pigs (7-8 weeks old) received 2,000 SWs at 24 kV (120 SW/min) with or without pretreatment with 100 SWs at 12 kV/2 Hz to the lower pole calyx of one kidney using the HM3. Four hours post-treatment, selected samples of renal tissue were frozen for analysis of cytokine, interleukin-6 (IL-6), and stress response protein, heme oxygenase-1 (HO-1). Urine samples were taken before and after treatment for analysis of tumor necrosis factor-α (TNF-α). Treatment with 2,000 SWs with or without pretreatment caused a statistically significant elevation of HO-1 and IL-6 in the renal medulla localized to the focal zone of the lithotripter. However, the increase in HO-1 and IL-6 was significantly reduced using the pretreatment protocol compared to no pretreatment. Urinary excretion of TNF-α increased significantly (p < 0.05) from baseline for pigs receiving 2,000 SWs alone; however, this effect was completely abolished with the pretreatment protocol. We conclude that pretreatment of the kidney with a low dose of low-energy SWs prior to delivery of a clinical dose of SWs reduces, but does not completely prevent, SWL-induced acute renal oxidative stress and inflammation.
authors.affiliation: Department of Anatomy and Cell Biology, Indiana University School of Medicine, 635 Barnhill Drive, MS 510, Indianapolis, IN 46202, USA. danlclar@iupui.edu
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Clark
authors.forename: Bret A
authors.initials: BA
authors.lastname: Connors
authors.forename: Rajash K
authors.initials: RK
authors.lastname: Handa
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Evan
mesh_terms: D000818:Animals; D005260:Female; D051547:Heme Oxygenase-1 / Q000378:metabolism; D019220:High-Energy Shock Waves / Q000009:adverse effects*; D015850:Interleukin-6 / Q000378:metabolism; D007668:Kidney / Q000378:metabolism / Q000503:physiopathology*; D008096:Lithotripsy / Q000009:adverse effects*; D023421:Models, Animal; D009393:Nephritis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D018384:Oxidative Stress / Q000502:physiology*; D011300:Preoperative Care; D013314:Stress, Mechanical; D013312:Stress, Physiological / Q000502:physiology; D013552:Swine
chemical_list: D015850:Interleukin-6; D051547:Heme Oxygenase-1